Friday, October 10, 2008 ibritz asks

Q: What questions do I need to ask when I have first appt with Neurologist?

I have thought for many years I have MS. Many of the symptoms are similar to those of Fibromyalgia, which I have been diagnosed with. Lately, I have had horrible tremors/shaking all over, and I have for the past 20 years been very sensitive to the heat and humidity. This has gotten worse year after year. I am seeing a Neuro week after next. What are the questions I need to ask? I have a list of all the symptoms I've had, meds, etc.

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Answers (3)

Lisa Emrich, Health Guide

10/11/08 5:22pm

Hi Ibritz,

Welcome to Health Central. One of the best ways to prepare for your first neurology visit would be to prepare a summary (or chronology) of your illness (and other diagnoses) and include:
§ When did symptoms begin? What symptoms did you have at the beginning?
§ What brought on the symptoms or made them worse?
§ What other symptoms have occurred? When did they occur?
§ What tests have been done? What were the results?
§ What medications have you taken? What were the results of the treatment?
§ List all current medications and the dose you are currently taking.

Some of the symptoms to consider including are: Changes in Vision; Vertigo; Weakness and/or numbness in arms/hands/legs/feet; Coordination problems in arms or legs; Balance problem; Trouble walking or falling; Speech problems; Memory loss/cognitive problems; Confusion/hallucinations; Decreased attention/concentration; Poor judgement/reasoning; Depression/anxiety; Fatigue (constant or intermittent); Bladder or Bowel problems; or Sexual dysfunction

Preparing the above information will likely bring more questions to mind. The neurologist will want to discuss your current symptoms and the history of symtoms. He/she will conduct a neurologist exam looking for clinical evidence of symptoms.

Further testing might include bloodwork looking for other causes of your symptoms, MRIs of brain/cervical spine looking for demyelinating lesions, evoked potential tests looking for damaged nerve function, and maybe a lumbar puncture looking for protein markers in the spinal fluid.

And after you've been diagnosed (or even before), here's a list of "10 Important Questions to Ask Your Doctor About Multiple Sclerosis" (found at WebMD)
§ Have you been able to rule out every other possible cause of my symptoms?
§ What form of multiple sclerosis do you think I have?
§ What drug(s) should I take to treat my MS?
§ How will I know if the drugs are working?
§ What side effects should I expect, and how should I respond to them?
§ Should I take steroids during an attack?
§ Is there anything else I can do to cope with attacks?
§ What do you recommend for treating the symptoms of my MS (like muscle spasms or pain)?
§ Do lifestyle changes, exercise, or physical therapy improve disability?
§ Are there any local support groups?

If this doesn't answer your question about questions, please let us know. Perhaps others reading will have some idea to add?

Thanks for your question. Lisa

Merely Me, Health Guide

10/13/08 3:03pm

Hey Ibritz

Lisa has already done an excellent job of giving you a very detailed response. So I will just add a few things here.

First of all...this is good that you are on the right path towards figuring out what is causing your mystery symptoms. It can be frustrating to be in this limbo land where you are not sure of what you will end up being diagnosed with. I can tell that you are well prepared for this visit already with your list of symptoms and medications. That is going to be very helpful to the doctor. You want to tell him or her about the intensity and duration of these symptoms. I would also tell your doctor that you are concerned it may be Multiple Sclerosis.

The first questions that come to mind to ask your doc for such a visit are:

* Which possible diagnoses will you investigate? When I went into my doctor for the first time with my list of symptoms I asked him point blank...what sorts of things will you be looking for?

* What tests will you need to do to find out what this is?

* What are the similarities between fibromyalgia and Multiple Sclerosis symptoms?

* What can I do in the meantime to deal with these particular symptoms?

I am guessing that if there is any suspicion of MS...that she will order an MRI for you.

Try not to be scared or alarmed at this point...I know easier said than done. You seem to be proceeding in a very logical way. You do not know that this is MS...it may very well not be. The best thing you can do at this point is to gather facts...and your doctor is going to know the best way to proceed. Only concentrate on what is pertinent at this point and that is to begin the process of elimination of possible diagnoses.

When you are at the beginning of things...and this may be a long road...I think it is best for one's sanity to only focus on what is right before you...and in this case it is fact gathering...writing down the symptoms to take to your doctor and then allowing him or her to do the necessary tests to get to the bottom of things. There are many things which could be causing your symptoms and to worry about them all will make you go crazy. Believe me...I know this from experience.

I wish you the best of luck. Please do come back to tell us what happens for your first visit. I will be thinking of you.

ibritz

10/22/08 10:18pm

I saw the neurologist Monday. I don't have MS. He answered most all the questions you all reccommended. He felt my meds were a bit out of wack, so made adjustments, increased one, decreased one, added one and deleted one. As well as the meds, he feels, as I do, that I am not getting enough restorative sleep. The tremors are Essential Tremors (can be hereditary - I'm looking in to that), Also diagnosed me with Restless Leg Syndrome (RLS) and Periodic Leg Movement while sleeping (PLMS). So I probably won't be back much to the site. Thanks for your help!

Q: What questions do I need to ask when I have first appt with Neurologist?

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